Addiction and Personal Responsibility: A Fundamental Conflict

Previously we explained we lack certainty as to the precise cause of addiction. It follows there is a lack of consensus about the most effective approach to treatment as well. However, our discussion about the causes of addiction would not be complete without a discussion of personal responsibility. This issue of personal responsibility leads to a great deal of controversy about addictions. This issue of personal responsibility is not unique to addictive disorders. People who develop hypertension and heart disease because of obesity face similar difficulties. So do cancer patients who smoke cigarettes. What each of these have in common is some part of the illness is due to life-style choices; things we have control over. Other parts of these illnesses have to with genetics; things we don't have control over. This creates a problem with respect to personality responsibility. Who caused the problem? Who should fix it?

Brickman and colleagues (1982) have presented a useful analysis of personal responsibility. Their analysis reveals there are two fundamental questions:

Who is responsible for creating a problem?

Moreover, who is responsible for solving it?

These two questions yield four possibilities with respect to responsibility for personal problems:

The Moral Model: People are responsible for creating and solving their own problems.

The Medical Model: People are not responsible for creating or solving their own problems.

The Enlightenment Model: People are responsible for creating, but not solving, their own problems.

The Compensatory Model: People are responsible for solving, but not creating, their own problems.

Extreme, exaggerated versions of model: Becoming crippled and ineffective because of extreme guilt and self-loathing; complete submission to authority; blindly following others.

Healthy recovery application: "Looking back, I see what I did to cause my addiction and I've learned from my mistakes. Now I'm going to follow the guidance and direction of a greater authority that can show me how to change my life (completely if necessary)."

Compensatory model:

"I'm not responsible for creating the problem, but I am responsible for solving it"